Participant-Directed Goods and Services (Code 333)

The one-sentence answer

Code 333 is the flexible category of the spending plan — it covers goods and services that meet a need in your IPP but do not fit any other service code, and it has its own test that every item must pass.

What this means for you

This is the code that makes Self-Determination feel different, and it is also the one most likely to be questioned. Anything genuinely useful that is not a standard service tends to land here, which is exactly why it gets scrutiny.

Every 333 item has to clear four hurdles. Three are absolute, and then you need one of three justifications:

All three of these must be true:

1. It links directly to an identified need or goal in your IPP. No IPP link, no purchase.
2. It is not already included in another service definition — no duplication. If something else covers it, buy it there.
3. There is no generic or community alternative. If a free or public option exists, use that first.

And at least one of these:

• It decreases the need for other Medicaid services, or
• It promotes interdependence and inclusion in the community, or
• It increases the person's safety in the home environment.

Write your justification in that language. A request that says "this relates to the communication goal in his IPP, there is no community program offering it, and it promotes inclusion" is answering the actual test. One that says "this would really help" is not, however true it is. The test is not a trick — it is the checklist your regional center is working from, so use the same words.

Code 333 is the most contested area in the whole program. Expect questions, keep your reasoning written down, and see Enclosure B for what is explicitly allowable and what is not.

For the detail-oriented

The governing guidance is DDS's SDP Updated Goods and Services, cover letter 8 July 2024, with Enclosure A and Enclosure B. This supersedes the January 2022 guidance and a November 2023 interim version — check the date on anything you are reading, including advice from other websites.

The four-part test above comes from the 2022 Enclosure C decision tree and is confirmed in Enclosure A.

General rules that apply to 333 alongside everything else in the plan: natural supports and generic services come first; all services must be provided by an adult who is qualified to do the work; a legally responsible person cannot be paid to provide services; and the spending plan must list each item's cost and identify provider types without naming specific providers, stay within the budget, and be approved by the regional center before implementation.

That last point catches people out — approval comes before you buy, not after.